Debator: The case of the convicted earth mother is an attack on women's free choice

What is most important: A mother's right to decide over her own body or the child's safety?

This question has resurfaced after a former homebirth midwife, Io Hultén, was found guilty in the Eastern High Court on Wednesday of gross and repeated negligence in her role as a homebirth midwife.

For the verdict is "unbelievably serious" for midwives and women's right to their own bodies and childbirth, according to a Facebook post from author and debater Johanne Mygind, who has closely followed the case.

A message she now expands on in P1 Morgen (https://www.dr.dk/lyd/p1/p1-morgen/p1-morgen-2025/fredag-5-sep-2025-11802533365).

- It's quite interesting that Io Hultén is being convicted in a case where no one has been harmed, she says.

Also read: Homebirth: An abortion should be allowed but never forced (https://www.dr.dk/nyheder/indland/jordemoder-en-abort-maa-gerne-foelge-kvinden-men-aldrig-forfoelge-hende) Archive photo: Io Hultén is convicted for upholding informed consent, according to debater and author Johanne Mygind. (Photo: © Ida Marie Odgaard, Ritzau Scanpix)

The case revolves around a home birth in 2019, where the midwife Io Hultén assisted. The birth was previously assessed as a "high-risk birth" because the woman had previously given birth by cesarean section.

The woman did not want to give birth in the hospital, and Io Hultén therefore got the couple to sign a document stating that they took responsibility for the decision to have a home birth. During the birth, green amniotic fluid was discovered, but Io Hultén nevertheless failed to inform the maternity ward.

Eventually, the birthing woman ended up in the hospital.

The baby was healthy and vigorous at birth, but Io Hultén was reported anonymously to the Patient Safety Authority and subsequently convicted in a district court in 2023 for violating her authorization. A midwife has a duty to involve the hospital in a home birth that is deemed risky.

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Appeal court reduces sentence

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When the verdict was handed down on Wednesday, Io Hultén was convicted under the Authorization Act, but her revocation of her authorization was reduced from indefinite to two years.

The 46-year-old woman denies guilt and hopes to appeal to the Supreme Court. This is stated by her defense attorney, lawyer Asser Gregersen.

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'The woman makes the choice'

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In the Eastern High Court, the birthing woman testified in favor of Io Hultén.

- In court, the woman tells Io Hultén, "You must not go to the hospital, you must not take notes and you must not tell the hospital what has happened," says Johanne Mygind.

It is the woman's choice, she emphasizes.

- It can be thought of, what one wants, but the woman makes the choice. That means that Io Hultén is being convicted for upholding informed consent.

With the verdict, birthing women can no longer rely on the fact that their informed consent applies. And they cannot rely on the fact that healthcare personnel do not exchange information without their consent, argues Johanne Mygind.

- It has said that they may. I think that is very serious.

Also read: Fathers, fathers and surrogate mothers are often forced out of the country: New law criticized for being unambitious (https://www.dr.dk/nyheder/indland/far-far-og-surrogatmor-tvinges-ofte-ud-af-landet-ny-lov-kritiseres-vaere-uambitioes)

When Io Hultén was first reported to the Patient Safety Authority, she chose to give up her authorization and instead work as a 'doula' – a kind of birth assistant. She did this for a number of years, but when more midwives became aware of her work, she was reported again – this time for practicing midwifery without a license. This has been reported by Politiken before (https://politiken.dk/danmark/art10524712/Jordemoder-Io-Hult%C3%A9n-mistede-retten-til-at-hj%C3%A6lpe-f%C3%B8dende.-Nu-skal-hun-i-retten-igen).

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Authorization over confidentiality obligation

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The Midwife Association, however, does not believe that the verdict will limit women's right to home births.

In the Health Act, it is stated that women have the right to give birth at home, just as they also have the right to have a midwife present when they give birth at home.

The verdict, however, concerns the rules that a midwife must follow with her authorization, says Lis Munk, chair of the Midwife Association. This involves a certain responsibility, just as it also involves limitations.

- The limitations are in line with what we are trained for, says Lis Munk.

- We must care for the uncomplicated spontaneous birth, and we must perform some examinations and interventions in that context, and that is what we must do.

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Dilemma-filled

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The prosecutor in the case focused on the fact that Io Hultén herself asked the couple in question to sign a document stating that they took responsibility for the decision to have a home birth. Therefore, Io Hultén knew that she was taking a risk by assisting with the home birth of the birthing woman.

But that does not change the fact that Io Hultén has been in a difficult dilemma, argues Johanne Mygind.

- If the woman had not been allowed to give birth with her, she would have given birth alone, and the risk would have been very high.

Johanne Mygind believes that there is a strong risk regime on Danish maternity wards.

- Many of the interventions we perform during childbirth - cesarean sections, inductions, epidurals - are performed on the basis of a risk assessment. That is, "we are afraid that something potentially, possibly could happen to the fetus."

With that, she means that many of the doctors' recommendations are based on risks.

- What you are afraid of is something other than what I am afraid of. Therefore, you should make the decision yourself, she says.

But when we talk about risk assessments, and there is an authorization that the law has determined is important to follow, is it not just to protect the woman, but also the child?

- I am forced to say something very controversial. As long as the child is still in the mother's womb, it is not an individual. We cannot make decisions on behalf of the child.

Is the child not an individual until it is born?

- Legally, as the law is today, it is not.

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More focus on accommodating all women

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Lis Munk does not believe that the Danish system is contributing to disenfranchising birthing women.

- But I would say that we have become more focused on the risks associated with pregnancy, childbirth and childbirth.

And it is important to keep an eye on when there is a real risk, Lis Munk expands.

- I also think we could be even better at accommodating women who want something other.

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Authorization Act

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In the Authorization Act, it is determined that midwives themselves can independently care for births, unless there are circumstances with the woman or the child that make the birth particularly risky. In such cases, the midwife must collaborate with a doctor on the birth.

If a private midwife wants to perform complicated births, the midwife, in other words, must have a so-called delegation from a doctor. If the midwife does not have this, she violates the Authorization Act.

The Patient Safety Authority had no opportunity to participate in an interview in P1 Morgen. But in a written response, the authority writes that it can invoke a midwife's authorization if the midwife endangers her patients to such an extent that less intrusive measures are not enough to ensure the patients' safety.

- If there is talk of a particularly gross negligence on the part of an authorized healthcare professional, such as a midwife, the Patient Safety Authority can hand over the case to the police, which assesses whether a criminal case should be brought for violation of the Authorization Act.

This applies to situations where both a child and a woman are endangered, and where a midwife goes far beyond the rules that are in the Authorization Act.

You can listen to both interviews in P1 Morgen here.

Warning: This article was translated by a Large Language Model, in case of doubt, you can always visit the original source.